Aging And Athletes: How Exercise Can Make A Difference

Increasing awareness of the benefits of exercise and longer lifespans is leading to more older patients seeking care for musculoskeletal injuries. Older individuals are more prone to overuse injuries and are slower to heal. Despite that, most researchers and clinicians agree that the benefits of exercise far outweigh the risks. The volume of research on aging is increasingly showing that there are physical, cognitive and psychosocial benefits to remaining physically active as we age.1

While age-related changes are unavoidable, research is suggesting that many of the declines previously associated with aging may actually be due more to a sedentary lifestyle that many older individuals adopt.2 Some researchers estimate that exercise can offset the decline by up to 50 percent.3-5 In addition, many older individuals also have chronic diseases such as hypertension, diabetes or obesity. Regular exercise has long been a recommended part of management for these conditions.

The known benefits of exercise bode well for our older patients and provide an opportunity to speak to them about remaining active or increasing their activity as they age. Montoye and colleagues found that college athletes who stop participating in sports have a rapid weight gain beginning at the age of 45.6 Conversely, even patients who have previously been sedentary can significantly decrease their risk of serious illness and risk of disability by starting a fitness program later in life.

The aging process starts earlier than many of our patients would suspect. Studies show some physiological and physical changes begin as early the third decade of life. This decline progresses in a relatively linear fashion until approximately age 60 to 70 when there is a steeper and more progressive drop-off.7 These age-related changes are inevitable of course but people can make them worse by inactivity.5

Understanding the physical and physiological changes of aging is important so we can tailor our patient education in order to promote physical fitness and help decrease the risk of injury.

Cardiac, vascular and pulmonary function decline at a rate of approximately 10 percent per decade after the age of 25.8 Decreased maximal heart rate and myocardial contraction combined with increased peripheral vascular resistance, diminished lung capacity and alveolar gas exchange are just some of the changes that combine to decrease the delivery of oxygen to muscles and other tissues. It is extremely important that all patients have a pre-activity exam/screening by a physician because underlying cardiac disease increases the risk of myocardial infarction and sudden cardiac death. For this reason, even fit patients should also have regular follow-up exams with their physicians to monitor for changes that might alter their risk factors.9

Neurologic changes manifest as a loss of nerve tissue including cerebral cortex and spinal cord axons, and the dysfunction of peripheral nerves.4 These losses affect not only cognition but coordination, fine motor skills, proprioception and balance as well. Dorfman found a 30 to 50 percent reduction in ankle proprioception and vibration sense in aged adults and noted that absent ankle reflexes are a common age-related finding even in the absence of pathology.10 Depression and some medications can also have negative effects on neuromuscular coordination.11